EMPTY SELLA SYNDROME SUBSEQUENT TO POST NATAL HYPOPITUITARISM: CASE REPORT

Koshila P.*, Ranganathan J. R., Vikashini S., Sheik Haja Sherief and Menaka

ABSTRACT

Sheehan's syndrome (SS), a postnatal hypopituitarism caused by sphacelus of the pituitary is typically the results of severe cardiovascular disease or shock caused by large hemorrhage throughout or once after delivery. Patients with SS have variable degrees of anterior pituitary gland endocrine deficiency. A 65-year-old women bestowed with clinical and laboratory options of endocrine, adrenal and thyroid deficiency. Endocrinological investigation showed anterior pituitary gland failure, that was in all probability a results of panhypopituitarism following blood loss throughout giving birth twenty seven years antecedently. Sheehan's syndrome was diagnosed. Computerized tomography scan of the skull revealed an empty sella. We suggest that pituitary sphacelus and involution allow penetration of spinal fluid to the sellar cavity through a defect inside the diaphragm sella, inflicting formation of associate empty sella. Its frequency is decreasing worldwide and it's a rare explanation for hypopituitarism in developed countries as a result of advances in obstetrical care. However, it's still frequent in underdeveloped and developing countries. Sheehan syndrome and empty sella syndrome typically evolves slowly and therefore is diagnosed late. History of postnatal hemorrhage, failure to lactate, cessation of menses, headache and visual symptoms are vital clues to the diagnosis. Early diagnosis and appropriate treatment are important to scale back morbidity and mortality of the patients.

Keywords: Haemorrhage, postnatal hypopituitarism, Sheehan’s syndrome.